策劃及捐助
合作院校
策劃及捐助
合作院校
香港每年約有六萬人離世，其中超過八成死因屬非急性疾病。當面對不治之症時，患者與家屬不僅承受身體的煎熬，更面臨心靈創傷、家庭壓力與情緒困境的連鎖衝擊。儘管醫療體系致力於疾病治療，但對晚期病患而言，如何在有限的生命時光中保持生活質素，成為更迫切的課題。加上，晚期病患者在社區比在醫院的時間較長。為此，香港賽馬會慈善信託基金於2016年策劃和捐助「賽馬會安寧頌」計劃，以跨專業實證為本的社區晚期照顧模式，讓病患在熟悉的環境中獲得專業支援，真正實現「心安、家寧」的願景。
經過多年努力，計劃在病患長者成功實踐及建立了有效的醫社合作模式；隨著計劃的社區教育及政府對晚期照顧的關注，大眾對晚期照顧的認識和接受度提升。香港賽馬會慈善信託基金看到有身體障礙、 智力障礙或精神復元的人士面對晚期疾病時，會有不同或額外的挑戰。基金於2024年發起並資助了另一項為期五年，名為「賽馬會安寧頌：融和篇」（JCECC: Unison）的計劃，旨在以現時對長者創建的社區安寧照顧服務模式，再調節切合這群體的特有需要及服務類型，開發出合理調整的服務模式，讓他們及其照顧者同樣地得到優質的社區晚期照顧。
「生之喜悅、逝之安寧 — 共建有選擇的未來」賽馬會安寧頌計劃一直以來見證這份信念的實踐。我們持續深化社區照顧網絡，透過「醫社合作」創新模式，讓每個生命都能在溫暖的支持中，寫下屬於自己的圓滿篇章。
晚期病患者和他們的照顧者在不同的情況會面對不同的挑戰；這些挑戰亦因人而程度有異，更多的是他們可能在同一時間面對多方面的挑戰。總括而言，挑戰可以在實務如徵狀控制、經濟、生活及照顧安排上，或在面對及處理自己和家人的情緒、關係、及社會資源及支援上，亦可以是心靈、生命意義的挑戰及需要。
患者和照顧者面對的挑戰及需要亦未必相同，透過精準的評估，切合需要的服務，才能提供適切有效的支援。
根據世界衛生組織（2020），紓緩治療旨在幫助病患者以及其家屬，在面對威脅生命的疾病時，提升其生活素質。紓緩治療透過及早辨識、全面評估以及治療，來預防及減輕因疾病帶來的痛楚以至身、心、社、靈的問題。紓緩治療既可以於疾病早期開始應用，也能與其他旨在延長壽命的治療同時進行。
世界各地對安寧照顧的定義各有不同，但都指向對步入生命最後階段的病患者所提供的照顧和支援 (National Institute for Health and Care Excellence, 2019)。每個人的「生命晚期」所牽涉的時間均不盡相同，通常都指生命最後幾個月甚至幾個星期，但對部分人來說可長達數年，包括：
預設照顧計劃通常指病患者、醫療服務提供者、病患者家屬或照顧者的一個溝通過程 (Food and Health Bureau, 2019; Health Bureau, 2020)。病患者可就未來的醫療或個人護理及照顧表達價值觀、意願和意向，商討當沒有精神行為能力作出決定時，他/她所屬意的醫療及照顧方式，或作出拒絕接受維持生命治療的預設醫療指示 (Food and Health Bureau, 2019; Health Bureau, 2020)。預設照顧計劃旨在讓病患者及家屬或照顧者得到符合他們意願的晚期照顧 (Sudore et al., 2017)。在香港，預設照顧計劃或作出預設醫療指示完全出於自願。
「預設醫療指示」是一份具有法律約束力的文件，讓成年病患者在有精神能力就維持生命治療作決定時，與家人及醫護人員進行深入討論，然後預先訂立指示 (Health Bureau, 2024)。一旦病情轉差，只要符合指示中訂明的先決條件，包括罹患未期疾病、處於持續植物人或陷入不可逆轉的昏迷，又或於罹患其他晚期不可逆轉的壽命受限疾病，在病患者沒有精神能力就維持生命治療作決定的時間，醫護人員便會遵從病患者的意願，不提供或撤去相關的維持生命治療。
香港賽馬會、香港大學、香港中文大學及非政府機構的持續合作和努力，將繼續強化安寧照顧服務，以全面照顧晚期病患者及其家屬在身、心、社、靈及實務的多方面需求。
World Health Organization. (2020, August 5). Palliative care. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/palliative-care
National Institute for Health and Care Excellence. (2019). End of life care for adults: service delivery. Retrieved from
https://www.nice.org.uk/guidance/ng142
Health Bureau. (2020). Consultation Papers: Public Consultation on End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place. Retrieved from
https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place – Consultation Document. Retrieved from
https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., Matlock, D. D., Rietjens, J. A. C., Korfage, I. J., Ritchie, C. S., Kutner, J. S., Teno, J. M., Thomas, J., McMahan, R. D., & Heyland, D. K. (2017). Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel. J Pain Symptom Manage, 53(5), 821-832.e821.
https://doi.org/10.1016/j.jpainsymman.2016.12.331
Health Bureau. (2024). Other Publications: Advance Decision on Life-sustaining Treatment Ordinance. Retrieved from
https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html
1 Chan, I. K., Fong, C. H., Wong, Y. E., Lou, V. W., & Chan, C. L. (2019). Innovation. Impact: The foundation of community based end-of-life care in Hong Kong. The Jockey Club End-of-Life Community Care Project. Retrieved from http://www.socsc.hku.hk/JCECC/case_book/HKU_SS_JCECC_book.pdf
2 賽馬會安寧頌（2018）。《「心安家寧系列：安寧概念篇》。取自http://www.socsc.hku.hk/JCECC/case_book/ngo_case_b5_o_rev1.pdf
3 Jockey Club End-of-Life Community Care Project. (n.d.). Background and Objectives. Retrieved from https://foss.hku.hk/jcecc/en/about-us/background-and-objectives/
4 Hospital Authority. (2017). Strategic Service Framework for Palliative Care. Retrieved from https://www.ha.org.hk/visitor/ha_view_content.asp?Parent_ID=224128&Content_ID=239624&Ver=HTML
5 Health Bureau. (2024). Other Publications: Advance Decision on Life-sustaining Treatment Ordinance. Retrieved from https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html
6 Hospital Authority. (n.d.). Palliative Care Service: About HA’s Palliative Care Services. Retrieved from https://www.ha.org.hk/visitor/ha_visitor_index.asp?Content_ID=10096&Lang=ENG&Dimension=100&Parent_ID=10085&Ver=HTML
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World Health Organization. (2020, August 5). Palliative care. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/palliative-care
National Institute for Health and Care Excellence. (2019). End of life care for adults: service delivery. Retrieved from
https://www.nice.org.uk/guidance/ng142
Health Bureau. (2020). Consultation Papers: Public Consultation on End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place. Retrieved from
https://www.healthbureau.gov.hk/en/press_and_publications/consultation/190900_eolcare/index.html
Food and Health Bureau. (2019). End-of-life Care: Legislative Proposals on Advance Directives and Dying in Place – Consultation Document. Retrieved from
https://www.healthbureau.gov.hk/download/press_and_publications/consultation/190900_eolcare/e_EOL_care_legisiative_proposals.pdf
Sudore, R. L., Lum, H. D., You, J. J., Hanson, L. C., Meier, D. E., Pantilat, S. Z., Matlock, D. D., Rietjens, J. A. C., Korfage, I. J., Ritchie, C. S., Kutner, J. S., Teno, J. M., Thomas, J., McMahan, R. D., & Heyland, D. K. (2017). Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel. J Pain Symptom Manage, 53(5), 821-832.e821.
https://doi.org/10.1016/j.jpainsymman.2016.12.331
Health Bureau. (2024). Other Publications: Advance Decision on Life-sustaining Treatment Ordinance. Retrieved from
https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html
1 Chan, I. K., Fong, C. H., Wong, Y. E., Lou, V. W., & Chan, C. L. (2019). Innovation. Impact: The foundation of community based end-of-life care in Hong Kong. The Jockey Club End-of-Life Community Care Project. Retrieved from http://www.socsc.hku.hk/JCECC/case_book/HKU_SS_JCECC_book.pdf
2 賽馬會安寧頌（2018）。《「心安家寧系列：安寧概念篇》。取自http://www.socsc.hku.hk/JCECC/case_book/ngo_case_b5_o_rev1.pdf
3 Jockey Club End-of-Life Community Care Project. (n.d.). Background and Objectives. Retrieved from https://foss.hku.hk/jcecc/en/about-us/background-and-objectives/
4 Hospital Authority. (2017). Strategic Service Framework for Palliative Care. Retrieved from https://www.ha.org.hk/visitor/ha_view_content.asp?Parent_ID=224128&Content_ID=239624&Ver=HTML
5 Health Bureau. (2024). Other Publications: Advance Decision on Life-sustaining Treatment Ordinance. Retrieved from https://www.healthbureau.gov.hk/en/press_and_publications/otherinfo/241100_adlto/index.html
6 Hospital Authority. (n.d.). Palliative Care Service: About HA’s Palliative Care Services. Retrieved from https://www.ha.org.hk/visitor/ha_visitor_index.asp?Content_ID=10096&Lang=ENG&Dimension=100&Parent_ID=10085&Ver=HTML
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